Does Incorrect Injection Site Affect HPV Vaccine Efficacy? - Family Medicine

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Is the HPV vaccine administered in the abdomen?


Two months ago, I received the first dose of the nine-valent HPV vaccine at my own expense.
During the administration, Nurse A informed me that the HPV vaccine is different from regular vaccines and should be injected in the abdomen, so I complied and stood still for her to administer the vaccine in that area.
Now, two months later, when I am to receive the second dose, Nurse B informed me that the HPV vaccine should be injected in the arm.
I was puzzled by the difference in injection sites between the first and second doses, and Nurse B took out the vaccine insert to research it.
She discovered that the insert clearly states that the Gardasil 9 HPV vaccine should be administered intramuscularly in the deltoid region of the upper arm.
My question is: Does incorrect injection technique reduce the vaccine's efficacy or have any adverse effects on the body?

Mala Sang, 20~29 year old female. Ask Date: 2022/09/07

Dr. Lin Zhebin reply Family Medicine


Hello: The Gardasil 9 HPV vaccine should be administered intramuscularly.
If it is given subcutaneously, it may result in increased pain at the injection site and more pronounced side effects.
If you do not experience any significant discomfort at the injection site or in your body within two months after the first dose, there is no need to worry too much about this aspect.
Regarding the efficacy of the vaccine, subcutaneous injection may lead to a slightly reduced ability to generate an immune response compared to intramuscular injection.
However, since you will receive the second and third doses to stimulate a continued immune response, there will still be protective effects.
It is recommended that you complete all three doses according to the suggested schedule.

Reply Date: 2022/09/07

More Info


The question of whether incorrect injection sites affect the efficacy of the HPV vaccine is an important one, especially given the confusion surrounding the appropriate administration methods. The HPV vaccine, particularly the nine-valent version, is designed to be administered via intramuscular injection, specifically into the deltoid muscle of the upper arm. This method is crucial for ensuring that the vaccine is absorbed properly into the bloodstream, where it can elicit an immune response.

When a vaccine is administered incorrectly, such as through subcutaneous injection (under the skin) or in an inappropriate muscle group, it can potentially lead to a less effective immune response. This is because the vaccine may not be delivered to the optimal site for absorption. For instance, intramuscular injections allow for a larger volume of the vaccine to be absorbed quickly and effectively, which is essential for generating a strong immune response. In contrast, subcutaneous injections may not provide the same level of absorption and could lead to a diminished immune response.

In your case, receiving the first dose of the HPV vaccine in the abdomen instead of the upper arm could raise concerns about the efficacy of that dose. However, if you did not experience any significant adverse effects at the injection site, it is likely that your body still mounted some level of immune response. The HPV vaccine is designed to be administered in a series of doses (typically three for the nine-valent vaccine), and the subsequent doses can help boost and solidify the immune response.

Regarding your specific concerns about the efficacy of the vaccine after an incorrect injection, research suggests that while the first dose may not have been optimally administered, the subsequent doses can still provide significant protection. The immune system can still respond to the later doses, especially if they are administered correctly. Therefore, it is crucial to complete the vaccination series as recommended, even if the first dose was not given at the ideal site.

Moreover, the HPV vaccine is effective against several strains of the virus that are known to cause cervical cancer and other HPV-related diseases. While it is true that the vaccine does not treat existing infections or diseases caused by HPV, it can help prevent future infections from the strains covered by the vaccine. This is particularly important for individuals who may have been exposed to HPV but have not yet developed any related health issues.

In summary, while incorrect injection sites can potentially affect the efficacy of the HPV vaccine, the overall impact may vary depending on individual circumstances. It is essential to follow up with your healthcare provider to ensure that you complete the vaccination series and discuss any concerns you may have about the administration of the vaccine. They can provide guidance and reassurance based on your specific health needs and vaccination history. Ultimately, the benefits of receiving the HPV vaccine far outweigh the risks, and it remains a critical tool in preventing HPV-related diseases.

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